Development of an assessment instrument for assessing dental fear in children

Frederick J Sutkiewicz, Marquette University

Abstract

The purpose of the study was to develop and validate a parent rating scale to assess dental fear in children between three and eight years of age. A review of the research indicated a lack of empirically supported assessment tools for children in this age group. Dentists have reported dental fear to be the primary interfering factor in securing regular patient care with adults. Other studies found that the majority of adults reported their dental fear began in childhood. As children are now going to the dentist earlier in life, the identification and subsequent elimination of dental fear early on may assist in increasing the regularity of patient care. This study was completed at a private pediatric dental practice in Racine, Wisconsin, and an inner city practice in Milwaukee, Wisconsin through Children's Hospital of Wisconsin. Participants included 126 children between 3 and 8 years of age and their parents or guardians. Parents completed the Dental Behavior Questionnaire which included 11 key items to be rated on a visual analog scale. Parents also completed a scale assessing general anxiety and health concerns. A select group of children completed the Children's Fear Survey Schedule: Dental Subscale and a child version of the Dental Behavior Questionnaire. The research results found the Dental Behavior Questionnaire to be a psychometrically sound instrument with a high level of internal consistency for the 11-item scale. The test-retest and inter-rater reliability were similarly elevated. Approximately two thirds of the children had not yet experienced an invasive procedure such as injections, drilling or placement of sealants. A strong correlation was noted between parent ratings and self-report measures for children seven years of age, but this relationship did not hold for children under seven years old. The child's general anxiety was a strong predictor of dental anxiety. Although the parental level of anxiety and quality of care were statistically correlated with a child's dental fear, they accounted for little variance in the child's level of dental fear. There were no effects for gender or age noted for the scale. There were no children who met the outlined DSM:IV criteria necessary for the identification of a specific phobia. The DBQ is considered to be a useful screening instrument given the ease of administration and objective scoring procedure.

This paper has been withdrawn.